0 Table of Contents |
1 PACIO Transitions of Care Implementation Guide |
2 Personas and Scenarios |
3 Use Cases |
4 General Guidance |
5 Discipline-Specific Required DEL Information |
6 Formal Specification |
7 Security, Privacy, and Consent |
8 Recommended Search Parameters |
9 FHIR Artifacts |
9.1 TOC CapabilityStatement |
9.2 Transition of Care Composition |
9.3 Reason |
9.4 Transitions of Care DEL LOINC Terms Value Set |
9.5 Transitions of Care LOINC Terms Answered by LL5571-6 Answer List Value Set |
9.6 Transitions of Care LOINC Terms Included in the DEL Answered by LL5571-6 Answer List Value Set |
9.7 Allergy List |
9.8 Anemia Diagnosis |
9.9 Constipation Diagnosis |
9.10 Depression Diagnosis |
9.11 Diabetes Diagnosis |
9.12 Discharge Care Plan |
9.13 Discharge Service Request for blood chemistry procedure |
9.14 Discharge Service Request for call order |
9.15 Discharge Service Request for complete blood count |
9.16 Discharge Service Request for discharge SLP referral |
9.17 Discharge Service Request for OT referral |
9.18 Discharge Service Request for protein diet |
9.19 Discharge Service Request for PT referral |
9.20 Discharge Service Request for reduced salt diet |
9.21 Dr. Anita Chu |
9.22 Dr. Gerald Park |
9.23 Dr. Jen Cadbury |
9.24 Dr. Nura Mekel |
9.25 Dr. Phil Chekhov |
9.26 Dr. Tracy Count |
9.27 Dressing Concerns |
9.28 Everyday Community Pharmacy Organization |
9.29 Happy Nursing Facility Organization |
9.30 Heart Disease Diagnosis |
9.31 Hemiparesis Diagnosis |
9.32 Hyperlipidemia Diagnosis |
9.33 Hypertension Diagnosis |
9.34 Kidney Disease Diagnosis |
9.35 Location of Michigan Primary Health Care Associates |
9.36 Location of the Everyday Community Pharmacy |
9.37 Location of the Happy Nursing Facility |
9.38 Location of the Neuro Care Inc. facility |
9.39 Location of the Not Every Day Contract Pharmacy |
9.40 Michigan Primary Health Care Associates Organization |
9.41 Minimum Data Set (MDS) Discharge Assessment - Lower body dressing |
9.42 Minimum Data Set (MDS) Discharge Assessment - Lying to sitting on side of bed |
9.43 Minimum Data Set (MDS) Discharge Assessment - Sit to stand |
9.44 Minimum Data Set (MDS) Discharge Assessment - Upper body dressing |
9.45 Minimum Data Set (MDS) Discharge Assessment - Walk 50 feet with 2 turns |
9.46 Minimum Data Set (MDS) Nursing Home Discharge Assessment for Activities Questions - Part 1 |
9.47 Minimum Data Set (MDS) Nursing Home Discharge Assessment Questions - Mobility Part 1 |
9.48 Nausea and vomiting |
9.49 Neuro Care Inc. Organization |
9.50 Neuropathy Diagnosis |
9.51 Not Every Day Contract Pharmacy Organization |
9.52 OT Decondition Problem List |
9.53 OT Right Weakness Problem List |
9.54 Patient - Betsy Smith-Johnson |
9.55 Role of Dr. Anita Chu |
9.56 Role of Dr. Gerald Park |
9.57 Role of Dr. Jen Cadbury |
9.58 Role of Dr. Nura Mekel |
9.59 Role of Dr. Phil Chekhov |
9.60 Role of Dr. Tracy Count |
9.61 Service Request to follow up with PCP |
9.62 Stroke Diagnosis |
9.63 Transition of Care Bundle |
9.64 Transitions of Care Clinical Document |
9.65 Undressing Concern |
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